Journal of Research on Leadership Education Volume 3, Issue 1 (May, 2008)
“AND THE BAND PLAYED ON”: DEVELOPING ETHICAL LEADERSHIP THROUGH A CASE STUDY OF THE AIDS CRISIS
Sarah Noonan Laurie Anderson Sathe University of St. Thomas
In 1912, the largest ship in the world, the RMS Titanic, sunk on her maiden voyage, claiming the lives of more than 1,500 people (Kamuda, n.d.). While the wealthiest passengers enjoyed first class accommodations on the upper decks of the Titanic, poorer passengers and crew occupied the decks below. When the ship hit an iceberg, cracking open at the seams and sinking nose first into the ocean, rich and poor alike suffered a tragic death. As panic spread, bandleader Wallace Hartley and the band played music on the deck in a futile attempt to calm the passengers and mask the real crisis of the situation (Wallace
Hartley, 2006). Later, band members took to the boats, singing or playing hymns to cheer those struggling to survive, now fully aware of the devastating catastrophe. As the ship sank, a wave overtook the band members and swept them into the sea.
Randy Shilts, author of And the Band Played On: Politics, People and the AIDS
Epidemic, uses the analogy of the sinking ship and the “band playing on” to draw attention to America’s false sense of security in the midst of the growing AIDS crisis. Like the drowning passengers and crew of the Titanic, victims of AIDS collided with an unseen and mysterious enemy during the early stages of the HIV/AIDS crisis. When AIDS killed gay men, intravenous drug users, or prostitutes, few rushed to their rescue. Some even viewed
AIDS as a biblical, punishing plague delivered without mercy to those who engaged in dangerous lifestyle choices. Later, when less marginalized and more privileged populations began to lose their lives, the concern about AIDS changed from ignoring a hidden disease to its designation as a public health issue. Noonan / AIDS CASE STUDY 2
In this article, we describe how students grew as critical, reflective, and ethical leaders through their study of the early days of the AIDS/HIV epidemic. Serving as an example of a leadership crisis and a moral dilemma, the case study of the AIDS epidemic provided an opportunity for doctoral students in a leadership preparation program to raise their critical consciousness and expand their capacity for moral action. Examining the decisions and actions of leaders in complex and politically-charged environments, students traced the influence of social, political, cultural, and economic factors on the private responses of AIDS sufferers and their loved ones to the deadly illness, as well as the public reactions of policy makers and institutional leaders to the emerging crisis. Using feminist, queer, and critical theory as tools for analysis, the case offered opportunities for students to see how cultural differences influenced the initial response of people and groups to AIDS, as well as see the impact of AIDS on the poorest populations in the world today.
We taught the AIDS case study within the doctoral “core” program. A brief description of the course goals and students follow.
The Doctoral Program and the “Core”
Students in a doctoral leadership program at a Midwestern university participate in a core curriculum (18 credits) as one component of their doctoral coursework. A sequenced mandatory curriculum known as the “core” serves as a foundation for their leadership study as well as their development as scholars. Students admitted yearly become members of an open cohort and attend a core curriculum class each semester over a three-year period with the other members of their cohort. Attending core classes one weekend a month, approximately 15-25 students begin their study each year. Approximately half of the students enrolled in the program have a background in K-12 education while the remaining students serve in higher education, business, medical, governmental or social service fields.
The core sets the stage for inducting students into the doctoral program and achieving the Noonan / AIDS CASE STUDY 3 overarching goals of the doctoral program. Students encountered the AIDS case study during their first semester of study.
The AIDS case represented about one-fourth of the course content for a three-credit class titled “Leaders and Organizations: Multidisciplinary Perspectives”. We selected the
AIDS case study to engage doctoral students in achieving the following course goals:
1. Deepen our individual and collective abilities to listen, reflect, and engage in critical
conversations about experiences of organizations with which we’ve been affiliated in
light of the multidisciplinary texts we will read.
2. Become more conscious of the narratives of our lives -- the people, critical events,
and intellectual traditions -- which have influenced how we interpret, value, and act.
3. Name and critique the dominant traditions, e.g. functionalism, structuralism,
positivism, that have shaped prevailing understandings of organizations and
leadership; consider the historical, philosophic, and cultural roots of those traditions
and the futures which those traditions suggest.
4. Examine and critique perspectives, e.g. critical theories, feminism, postmodernism,
which challenge dominant traditions; consider their roots and the futures they
suggest.
5. Articulate our ongoing constructions of meaning about educating and leading.
6. Improve narrative and analytic writing skills.
The AIDS case study supported the course goals described above in partial fulfillment of the course goals.
Armed with ambitious goals and a rapid pace of learning, we selected the
AIDS case study because of the opportunities within the case for students to grow as moral leaders, critical thinkers, and scholars. In the next section we describe moral development theory and relate this theory to the aims and methods of critical Noonan / AIDS CASE STUDY 4 pedagogy. These serve as the rationale and anchoring concepts that explain why we selected the AIDS case study.
Moral Development
The study of the early stages of the HIV/AIDS epidemic offers ample opportunity for a “moral education” due to the complexity and ethical tensions found within the case. Moral development, a precursor to ethical leadership, involves the capacity to see a situation as moral, imagine alternative courses of action and their impact, and take action despite the personal costs often associated with difficult decisions. Rest (1986) describes four psychological processes necessary for moral behavior including: (1) moral sensitivity, (2) moral judgment, (3) moral intention, and (4) moral action (pp. 3-18). A moral identity is eventually integrated with an adult character, identity, and personality. Becoming “one person” in adulthood, individuals are now capable of moral judgment and motivation leading them to moral action (Bergman, 2002, pp. 122-123).
After an extensive review of literature related to ethical leadership, Ciulla (1995) recommended simplifying the focus of leadership ethics research to a simple question:
“What is good leadership?” (p. 13). Addressing both ethical and effective leadership, Ciulla describes “two senses” of good leadership:
As we have seen from the examination of definitions, the ultimate question in
leadership studies is not ‘What is the definition of leadership?’ The ultimate
point of studying leadership is, ‘What is good leadership?’ The use of the
word good here has two senses, morally good or technically good or effective.
These two senses form a logical conjunction. In other words, in order for the
statement ‘She is a good leader’ to be true, it must be true that she is
effective and she is ethical. (1995, p. 13)
Noonan / AIDS CASE STUDY 5
Being “morally good” assumes moral knowledge and capacity, including knowledge of ethical philosophy and reasoning and its application to real-world dilemmas. Being “technically” good may relate more specifically to the strategies employed by effective leaders in the pursuit of goodness—strategies that pass both a moral “means” and “ends” test. We assume moral or ethical leadership precedes
“effective” leadership, while also recognizing that moral leaders must also be
“technically” good to achieve the goals of ethical leadership. Focusing on the development of moral intelligence, imagination, and character, our goal is to develop leaders who are capable of framing issues, examining alternative ethical perspectives among competing choices, and taking action out of goodness toward others. Unable to avoid ethical choices, democratic leaders must recognize that ethics and morality are at the center, not the edge of leadership.
“Good” leaders define a situation as moral by identifying not only “what” decisions and actions are potentially involved in a situation, but also who benefits or suffers from various alternatives. Related to social justice, the capacity for ethical leadership involves not only moral development, but also cultural knowledge and sensitivity. An important factor in ethical leadership is the idea of a “moral community”, which consists of those within our family or tribal system worthy of our protection and love.
Clayton and Opotow (2003) elaborate on the concept of moral community, referring to members as those who fall within “the scope of justice”:
Inclusion in the scope of justice, addressing the contingency, “who,” concerns who is
inside or outside our psychological boundary for justice, called the scope of justice
(or moral community). Moral considerations guide our behavior with individual and
groups included in our scope of justice (Deutsch, 1975). Moral inclusions means we Noonan / AIDS CASE STUDY 6
apply considerations of fairness to them, see them as entitled to a share of
community resources, and are willing to incur sacrifices to help them. (p. 301)
In contrast, those who are outside of the “scope of justice” are not protected from harm and may be “eligible targets for exploitation and violence” (Opotow,
1990, 1993) (p. 301). Although a few are capable of naturally expanding the scope of justice to include the “stranger” who resides outside of our individual experience, most of us need educational experiences to increase our moral sensitivity and actions toward (diverse) Others. Individual and social identities influence our idea regarding who is a member of our tribe and therefore worthy of inclusion in the scope of justice. The size of our moral community, bounded by the range of our life experience and education, affects our individual and collective moral development and capacity for ethical leadership.
A moral education engages learners in the study of cognitively-complex problems, situations, events, and theory, expanding students’ capacity to consider and sort through diverse perspectives, while simultaneously acknowledging and keeping their inherent bias at bay.
Cognitive complexity allows thinking that moves from the concrete to the abstract as
well as a meaningful integration of incoming or new information to construe the
various associations that might exist between apparently independent concepts and
ideas. Simply put, cognitive complexity increases the leaders’ range of sense
making about incoming information and may reduce simplistic stereotyping of
diverse groups. (Karim, 2003, p. 36)
When considering issues of justice, students might think more critically and ask: “Whose perspective on justice is being considered? What is their status in relation to others in the situation? What other entities are being excluded from the Noonan / AIDS CASE STUDY 7 realm of moral consideration?” (Clayton & Opotow, 2003, p. 299). An essential ingredient of moral sensitivity and judgment, knowledge and experiences of culture difference and identity allow us to both ask and answer the questions posed above.
This requires “critical seeing” through a cultural lens:
Through the lens of identity, pressing justice issues and the impact of social
changes come into focus, and through the lens of justice, identity takes on
deeper significance. A recognition and consideration of the fluidity of identity
allows us to be cognizant of the ways in which justice may be contingent on
changing circumstances. (Clayton & Opotow, 2003, p. 308)
Leaders, aware of the nature of social groups and the tendency toward moral exclusion of marginalized members, look closely at how justice may be defined and carried out based on cultural difference. Using a variety of theories for analysis, a moral education requires students to examine how societal forces (historical, political, social, cultural, and economic) add context to the situation and move leaders toward certain solutions based on how the situation is understood and defined (Noonan, 2003). These components of a moral education related to cognitive complexity, cultural difference, moral development, and ethical thinking and reasoning (to name a few), appear to be strongly correlated to the work of critical pedagogy. Critical pedagogy serves as an educational strategy for the moral development of ethical leaders.
Critical Pedagogy
Critical pedagogy engages learners in the process of developing their critical consciousness: defined here as an ability to see how people experience the world differently as a result of race/ethnic, gender, class, and/or cultural differences, as well as assess the impact of these differences on access to resources and Noonan / AIDS CASE STUDY 8 opportunities to fully participate in society. Engaging learners in “critical seeing”
(Eisner, 1991), critical pedagogy helps students detect how privilege, power, and position allow some individuals and groups to enjoy advantage, inclusion, and visibility, while others experience disadvantage, exclusion, and invisibility. Seeking to
“interrupt particular historical, situated systems of oppression” (Lather, 1992, p.
120), the goals of critical pedagogy are to recognize the detrimental effects of privilege on both advantaged and marginalized populations and work toward greater levels of social justice.
Critical pedagogy, a teaching and learning theory and method aimed at producing individual perspectives and advancing social justice, seeks to awaken critical consciousness, potentially leading to “transformation, liberation, emancipation, and empowerment” (Brookfield, 1995, p. 209). Gains in cultural knowledge and sensitivity as well as a growing awareness of the perspectives and experiences of others raises consciousness, a necessary ingredient for personal and social change.
A gradual and developmental process, cultural awareness progresses in three stages: “(1) awareness of superficial cultural traits, (2) awareness of significant and subtle cultural traits that contrast markedly with another’s, and (3) awareness of how another culture feels from the insider’s perspective” (Chen & Starosta, 2006, p.
358). The first two stages may be pursued through study, engagement with others, and reflection. The third stage (if ever achieved) is primarily accomplished through cultural immersion and mentorship. Cultural awareness supports critical seeing by revealing to students the impact of their experiences on their perspectives and judgments of others. “When naïve views are replaced with cultural knowledge, experience and appreciation, culturally-conditioned defense mechanisms are minimized and replaced with openness to the ideas, interpretations and experience of others” (Noonan, 2006, p 6). Noonan / AIDS CASE STUDY 9
Replacing social isolation with sustained engagement with others increases students’ willingness to see others and fight against their oppression. The AIDS case study provided opportunities for students to gain knowledge regarding how race, class, gender, and sexual orientation limited access to resources during the early day of the AIDS crisis and continues today. In the next section we present the specific methods and responses of students to each aspect of the case study including: the story of the early years of the AIDS crisis, the theoretical analysis using queer, feminist and critical theory, online discussion, class assignments, and the design of experiential learning stations. We also provide evidence of critical thinking and consciousness through the students’ personal reflections.
AIDS Case Study Content and Methods
We selected and organized a case study of the AIDS crisis to analyze the role and decisions of leaders charged with responding to the global threat of AIDS during the early days of the epidemic. This historical case study offered an opportunity to see the failure of leadership and its short and long-term effects as well as examine the important role social activist leaders played in creating social change. We also selected this particular case to cause students to examine how race/ethnicity, class, gender, and sexual orientation influenced the actions of leaders as well as the varying social responses to the growing AIDS epidemic. We first describe the AIDS epidemic and then follow with examples of the way we organized their learning activities including online discussion, lecture, assignments, small group activities, and creative projects.
Politics, People and the AIDS Epidemic
Despite advances in medical knowledge and international awareness of HIV/AIDS, the following statistics reveal HIV/AIDS as a continuing threat to global health:
Noonan / AIDS CASE STUDY 10
• By the end of 2005, 40.3 million people were living with HIV/AIDS, including
17.5 million women and 2.3 million children under the age of 15
• 4.9 million people became newly infected with HIV in 2005, including 700,000
children. Of these, 3.2 million new infections occurred in Sub-Saharan Africa
• In 2005 alone, a total of 3.1 million people died of HIV/AIDS-related causes
• World-wide, only one in ten persons infected with HIV has been tested and
knows his/her HIV status (Global Health Council, 2005, ¶ 3)
The early years of the AIDS crisis revealed both the opportunity for ethical leadership and the political and social challenges that tragically prevented its early containment as a global health crisis. Reading about the early stages of the AIDS crisis allows students an opportunity to examine how decisions made in the early 1980s affect us today.
Randy Shilts, author of And the Band Played On: Politics, People and the AIDS
Epidemic, wrote the definitive story of the early years of the AIDS crisis, offering a nearly daily account of the first 5 years of the AIDS crisis. Shilts exposes those whom he believed participated in ignoring the looming threat of AIDS including: bathhouse owners, the San
Francisco Health Department, blood bank operators, homosexual rights groups, the media, public health authorities, the pharmaceutical industry, sexually promiscuous gay men, and the Reagan Administration. He also describes heroic leaders and leadership found within the gay community, elected officials, physicians, members in the health care field, academic researchers, and professional staff at the Center for Disease Control (CDC). Thick with description and written in gripping detail, the book offers an insider’s view of gay subculture, political pressures and politics, the human side of the disease, and the unraveling scientific mystery of the AIDS virus.
The individuals featured in the book captivate the reader’s interest and portray leadership from a variety of perspectives. The narrative of the crisis and the character development of key actors in this real-life drama engaged students cognitively and Noonan / AIDS CASE STUDY 11 affectively to the story. Because story helps us to see particularities of cultural difference
(Fetterstone, 1992) and also recognize our relatedness as human beings, the AIDS case study offered students an opportunity to experience the effects of AIDS on people in a close and personal way, setting the stage for their transformation. Each of the stories interwoven into the history of AIDS allowed them to see the struggles and values of the populations they represented. The following illustrates the various contributions of the characters (real people in this dramatic story) and the organizations they symbolically represent:
Michael Gottlieb’s story represents the stories of physicians who cared about their patients with AIDS, but found that the homophobia of the community prevented them from receiving the funding they needed to continue their work. Throughout the book, Gottlieb is committed to understanding the virus that was afflicting his patients. His frustration was evident as he attended a national conference but experienced no opportunities for funding.
Shilts describes Gottlieb’s concerns:
The NCI conference fueled Gottlieb’s suspicion that no one cared because it was
homosexuals who were dying. Nobody came out and said it was all right for gays to
drop dead: it was just that homosexuals didn’t seem to warrant the kind of urgent
concern another set of victims would engender. Scientists didn’t care, because there
was little glory, fame, and funding to be had in this field: there wasn’t likely to be
money or prestige as long as the newspapers ignored the outbreak, and the press
didn’t like writing about homosexuals. So nobody cared, and all Michael Gottlieb
could do was return to Los Angeles to preside over more deaths. (Shilts, 1987, p.
95)
Paul Popham’s personal struggle and service as the first president of the Gay Men’s
Health Crisis represented the experiences of gay leaders who originally hid their sexual preferences, preferring to avoid discrimination and potential damage to their professional careers. Unable to ignore the growing realization that they faced discrimination in the lack Noonan / AIDS CASE STUDY 12 of support or funding for AIDS treatment, some gay leaders reluctantly “outed” themselves by forming a political organization to find a cure for AIDS and establish a support network for those dying of the disease. Paul’s awakening is part of the story.
[T]the government would do as little as possible to research AIDS as long as only
homosexuals were dying. This thought bothered him. Before AIDS, Paul had never
believed that gays really were all that oppressed; now he was worrying about
wholesale employment discrimination and quarantine camps. Paul had spent a
lifetime believing in his nation, and he had fought in Vietnam to protect it. One of his
greatest disappointments in the AIDS epidemic was that he felt robbed of his faith in
the United States. (p. 470)
Senator Waxman’s story represented the experiences of elected officials and the political implications of funding decisions. Decisions were made based on acceptability of the population with the disease rather than on the health issues or mortality of the disease.
Speaking out against discrimination, Waxman says, “I want to be especially blunt about the political aspects of Kaposi’s sarcoma. This horrible disease afflicts members of one of the nations most stigmatized and discriminated against minorities. The victims are not typical
Main Street Americans. They are gays, mainly from New York, Los Angeles, and San
Francisco” (p. 144). Many leaders noted and objected to the discriminatory practice reflected in the immediate and dramatic government effort to find a cure for Legionnaire’s disease and the pitiful response of the government to AIDS.
Don Francis, a legendary CDC researcher and important character in this story, relentlessly pursued the mystery of AIDS, collaborating with leading researchers. Working with outdated equipment, submitting repeated requests for federal funds, consulting with researchers in academic and medical settings, Francis’s tireless effort serves as a wonderful example of servant and ethical leadership. Deeply troubled by the moral issues involved in the effort to thwart AIDS, he wrote in his journal, Noonan / AIDS CASE STUDY 13
If I had to blame one thing it would be the hunger for power. Somewhere in our
pursuit of understanding AIDS, we have failed to turn the corner, to realize that we
did understand it, and do something about it. I blame most the Washington
hierarchy who cared more about reading the scientific discoveries as political wares
than public health breakthroughs. (p. 546)
Launching the AIDS case study, the book effectively set the stage for the students’ study of leadership, including the influence of race/ethnicity, class, gender, and sexual orientation on the treatment of AIDS sufferers. Students read the book before class, and we then explored the basic content of the book through class discussion. We prepared questions and also played film clips from the Home Box Office production of the documentary, And the Band Played On (1993). Using the backdrop of the early years and the current context for AIDS, we asked students to use theory to gain perspective about the crisis, its antecedents, and current status as a global health threat.
Applying Critical, Feminist and Queer Theory to the AIDS Case
We provided assigned reading and lectured on critical, feminist and queer theory, providing background for their analysis. Leading a discussion of the AIDS case, we provided examples regarding how theory might be used for analysis, asked them for examples and then organized them into small learning groups to continue with this analysis. We observed and interacted with them as they moved back and forth between a discussion of the meaning of various theories and their use in analyzing the AIDS case.
Using the AIDS case and critical, feminist and queer theory, we explored how the peoples’ lives and experiences, historical events, and decisions might be deconstructed and understood. (Please note: We do not intend to describe these theories in detail here nor do we claim expertise in any theoretical approach, but instead we attempt to show how aspects of these theories were used in the analysis of the AIDS case). The possibilities of applying these theories to the AIDS case seemed endless. Noonan / AIDS CASE STUDY 14
Critical theory
Critical theorists believe that philosophy must be engaged with the great struggles and social movements of its times (Noddings, 1998). Critical theory applied to the AIDS case and studied from a historical perspective takes into consideration the political and social context of the time as well as the evolution of the crisis in the current political climate. Taking it to the personal level, students as critical theorists evaluated the societal impact of a social issue on individuals. In The Band Played On, students learned the names of the first AIDS victims through a list described as the “butcher’s bill”, a death count of
AIDS victims kept by CDC researcher Dr. Don Francis. A victim of AIDS, Shilts chronicles the ongoing demise of the lives of individuals with AIDS and the repeated futile call for action and request for research funds. He compared the lack of response to AIDS with the national response to Legionnaire’s Disease, claiming that because AIDS was a disease of gay men, no one cared.
Class discussions of philosophy centered on the unethical behavior of health care providers who disregarded the Hippocratic Oath and failed to properly care for patients.
Students also questioned the ethics of resource distribution based on perceived value of the group or population with a disease where homosexuals with AIDS were a low priority. As students discussed issues of power and capitalism, they used a critical lens to examine the drive of pharmaceutical companies to sell medications, often putting profit above treatment protocols. They also questioned the actions of politicians who approved the expenditure of health care dollars devoted to the cure of socially-acceptable diseases while ignoring AIDS sufferers.
An African student described the social impact of young workers in Africa acquiring
AIDS, wrecking havoc on their families and wiping out future generations of leaders, citizens, and workers. Students discussed the impact of political promises of “no new taxes”, including the decrease of government investment in human services during the Reagan era causing unethical delays in research and social support. Identifying the lack of moral will to Noonan / AIDS CASE STUDY 15 address health issues on a global scale, students agreed that we are losing ground in the fight against AIDS and lack an ethical response to the needs of its victims. As the discussion progressed, the students’ growth in “critical consciousness” became self-evident. Noddings
(1998) explains the relationship between critical thinking and moral purpose in her book:
“Logically, we do not need a moral reason for adopting strong critical thinking, but practically most of us do, and without a moral purpose, even the strongest critical thinking may be rudderless” (p. 93).
Feminist theory
The overlay of feminist theory on the AIDS case reveals the patriarchy embedded in the perspectives of the leadership perpetuating male heterosexual privilege and an underlying homophobia. Code (2004) describes feminism as “a theoretical project committed to producing critical-constructive analyses of systemic power structures, theoretical presuppositions, social practices, and institutions that oppress and marginalize women, and to effecting social transformation” (p.xix). Some feminists argue that patriarchy is so pervasive that it is invisible until named by people who experience its oppressive effects. Because the primary focus of the AIDS crises was on male victims, the plight of women with AIDS was invisible until their stories were told.
Using feminist theory, students became more aware of the hidden, but growing population of women who have AIDS. The explosive and alarming rate growth of AIDS among women and children helped students see the impact of poverty on the spread of
AIDS. In addition, the stigma attached to the disease creates a new source of oppression and exclusion of women on a global scale. Feminists also emphasize the experience of women in the intersection of race, class, and sexual orientation. Their analysis must also include the impact of each of these social constructions on women’s oppression.
A feminist ethic of care asks that we live our lives and make decisions to create a less violent and more caring world. For an ethical response to a moral crisis, we need to
“turn to our memories of caring and being cared for and [create] a picture or ideal of Noonan / AIDS CASE STUDY 16 ourselves as carers” (Noddings, 1998, p.187). This ethic may be universally applied to the experiences of men, women, and children impacted by AIDS. Students used feminist theory to examine their individual and community responses to AIDS related to Noddings’ description of caring for others. When students exposed the role of gender, sexual orientation, race and class in their analysis of the AIDS case, they recognized how both patriarchy and moral exclusion of marginalized people (gay men, drug users, Haitians, and impoverished women and children) played a key role in the decision-making patterns of the
“leaders” in the AIDS crisis.
Queer theory
Queer theory, originally a political strategy, became a subsequent theory growing out of the AIDS crises in the 1980s. It began as a rallying cry from within the gay community for homosexuals to come together with a focus on the epidemic rather than on their differences. As a political strategy, it promoted radical activism (political organizing and education) in response to the growing homophobia triggered by the public's response to
AIDS. Grounded in gender and sexuality, queer theory challenges the identity categories of male/female and blurs the distinction between heterosexual/homosexual men.
First introduced by Teresa de Lauretis in 1991, queer theory challenges boundaries on several levels:
Queer theory continues the postmodernist project of playing with boundaries of such
sacred binaries as male-female and black-white by deconstructing the heterosexual-
homosexual bifurcation of sexual identity. (Brookes & Edwards, 1999, ¶1)
Queer theory causes a disruption of sexual categories calling into question the stigma of homosexuality and AIDS.
Pushing against heterosexual norms, class discussions of queer theory moved students into conversations about the lifestyle of people who are gay as a culture, causing new learning and some discomfort for many students. We discussed how to theorize but not Noonan / AIDS CASE STUDY 17 necessarily agree with different conceptions or approaches – emphasizing how scholars use theory with a subject matter or with discoveries even though it reveals a lifestyle that goes against their values. While most students easily grasped concepts related to critical and feminist theory, many struggled with queer theory. The discussion regarding the distinctions between biological differences and gendered constructions of identity as well as the notion of a hybrid identity (constituting neither a primarily “masculine” nor “feminine” identity), proved enlightening to some and disturbing to others. Prior to the discussion of queer theory, we asked students to suspend judgment, really listen to each other and recognize the varying experiences of group members related to the subject matter. A thoughtful and respectful discussion ensued.
During the case study of AIDS, the film Brokeback Mountain (Schamus, J. & Lee, A.,
2005) was released. A few of our students residing in conservative Midwestern communities found that their theater owners choose not to show the film. Upset with local homophobic attitudes and censorship, a few students contacted their local theaters and demanded a change in their position, questioning them about their decision and view of community mores. We saw these actions as evidence of their awakening using critical, feminist, and queer theory.
The examination of the AIDS case also created some consternation among some students who possessed religious beliefs opposed to same-sex preferences and lifestyle.
Meanwhile, others with considerable experience with the impact of bias and poor treatment on their loved ones who were homosexual, shared their stories and perspectives. We monitored discussions, emphasizing the importance of dialogue in understanding the experience of others through empathetic listening. We also planned a variety of learning activities (beyond theoretical analysis described above) to raise student awareness regarding the impact of AIDS. We asked them to examine the response of leaders during the early years of the AIDS crisis and reflect on its impact. The activities and examples of student reflections on their experience follow. Noonan / AIDS CASE STUDY 18
Learning Activities, Assignments, and Reflections
Aware of the varying developmental stages of our students related to cultural knowledge and sensitivity, we established conditions for dialogue, creating various “entry” points into the discussion of difference; offering various theories and methods for analysis; providing a series of experiential and inquiry-based approaches to AIDS case study; and encouraging student reflection and growth. Designed to advance both the cognitive and affective development of students, we challenged students to grow in their willingness to see the complexity of multiple perspectives, increase their empathy for others, and critically examine their assumptions about diversity, justice, and ethical leadership. Prior to the class meeting, students participated in an online discussion.
Online Discussion
To facilitate the reading before class and in anticipation that some students may have difficulty with the text, we created an online discussion prompt for the students to respond to and discuss the issues of the case with one another. The following prompt was established one month before the reading and paper were due:
The text engages us in our course objective to deepen our individual and collective
abilities to listen, reflect and engage in critical conversations about experiences of
organizations. The goal is to become conscious of the narratives of our lives and the
lives of others that influence how we interpret, value and act. With this in mind,
reflect and comment on Shilts’s proclamation: ‘The bitter truth was that AIDS did not
just happen to America-it was allowed to happen by an array of institutions, all of
which failed to perform their appropriate tasks to safeguard the public health. This
failure of the system leaves a legacy of unnecessary suffering that will haunt the
Western world for decades to come’. (1987, p. xxii)
Noonan / AIDS CASE STUDY 19
Student comments, questions and reflections reveal their concern and growing perspective regarding the AIDS crisis:
JX analyzed the case and began to use a more critical eye on current leadership practices: “This book certainly did lay out failures at every possible level in addressing the epidemic. While I still tend to believe that in general, people try to do the right thing, this book gave me a more cynical outlook on the motivations of our leaders.” In a discussion thread titled ‘inner conflict’, DX described his/her inner conflict of compassion and voices his/her concerns regarding a homosexual lifestyle.
While reading, And the Band Played On, my heart and brain had conflicting thoughts
concerning the mirage of missteps and constraints involved with this epidemic. My
heart wants to do everything possible to stop this disease as quickly as possible. But
my brain shouts, ‘Can't you see even those informed and educated continue to use
unsafe practices that cause AIDS?’ My brain counter attacks, ‘There is only so much
time and money. Many of the diseases known to man have no cure. If only those
with a gay lifestyle were allowed or would practice monogamy.’ “My heart continues,
‘Who are we to judge which diseases are funded and which ones are not.’
In a discussion of the movie, Brokeback Mountain, HX commented about the response of conservative communities to the differing sexual preferences:
I believe films such as Brokeback Mountain challenges [sic] us to look at life from a
different perspective. I don't know if the film will come to rural areas because the
conservative values expressed by one person in the newspaper article predominate
in a Midwestern state. His values from my viewpoint are really archaic.
HX recognized the way public opinion imposes dominant views and values, often limiting freedom. By the time we met in class, an on-going dialogue about moral leadership, cultural values, and societal forces shaping leadership had begun. Noonan / AIDS CASE STUDY 20
Assignments prior to the class meeting
We offered students a choice regarding their assignment. The first assignment required them to complete a critical analysis of leadership based on the widespread failure of elected officials and governmental institutions to respond to the AIDS crisis. The following directions describe the requirements:
Turn your “critical eye” to the crisis of leadership and AIDS. Drawing from several
texts, examine the issue of leadership through the lens of those affected by the
disease. Discuss the participation and response of “leaders” to the AIDS crisis,
drawing from Noddings (1998), Morgan (1997) and others sources to support your
argument and analysis. Discuss your understanding of leadership in this context and
what it means for your future development.
If a student chose assignment number two, they were asked to:
Interview an individual who is directly involved with or affected by the AIDS crisis.
Put a name and experience to the disease. Write up your notes from this interview
and identify the central themes. Drawing from the texts, interpret and explain what
you learned about leadership and what it means for your future development.
Students enjoyed the opportunity to select from two options and enthusiastically tackled the assignments, bringing their papers to class during the AIDS case study weekend (held from a Friday evening to Saturday afternoon, a 12-hour class meeting). The following excerpts reveal their deepening awareness and understanding:
JY, a long time resident of Midwestern state, looked at both his personal and professional experiences with AIDS:
Noonan / AIDS CASE STUDY 21
I will offer a perspective in this essay about AIDS education in a Midwestern state,
then and now, and my own personal experience with a close friend who died from
the disease in 1998. In 1988 I was a program representative in a Midwestern
Department of Education and Cultural Affairs. In my Midwestern state, we hired [for
the first time] a specialist to provide curriculum and programming for AIDS
education. I supported this position and learned an incredible amount about the
disease, the politics, and how difficult it is to present the topic to a rural population.
In my state we had a growing number of AIDS patients due to individuals coming
home to die. Everyone was well aware you would not come to this Midwestern state
for AIDS treatment, so it had to be to die. AIDS has a completely different meaning
for me today than it did twenty-five years ago. The greatest change came as a result
of a dear friend who lost his life in 1998 to this horrible disease.
Another student, RX interviewed an AIDS educator who related stories of people returning home to die and shared part of her story:
During this time she came to know a small number of AIDS sufferers. Likewise, she
acquired an understanding of our society’s misconceptions, fears, complacency and
denial. She witnessed firsthand the humiliation and alienation resulting from this
cruel illness [sharing the following story]: As his illness progressed, Ted returned to
his southeast Midwestern state hometown, where he later developed pneumonia. He
became desperately ill and required hospitalization in one of the state’s smaller
cities. At first the hospital simply refused to admit him. Pressure from a local
authority figure, however, finally forced the hospital to comply. The family felt a
degree of relief until they realized Ted had been quarantined…. The nurses refused to
touch him. Wearing surgical scrubs and rubber gloves, they routinely placed his
cutlery and food trays into a trash bag after each meal. Beyond mealtime, Ted was
left in total isolation in a room at the end of the hall—far away from other patients. Noonan / AIDS CASE STUDY 22
RX’s response at the close of his paper reveals his ethical leadership: “If we are to consider ourselves civilized, we must reach beyond ignorance and bigotry to something wiser and more compassionate.
JX looked at the local or statewide response to AIDS and their lack of attention to the lessons that could be learned from the historical experience in other states:
We are fortunate today to understand the epidemiology of AIDS and to have the
necessary tools to combat the spread of HIV. This Midwestern state has chosen to
believe that AIDS is not an issue in rural America, and therefore it should be swept
under the rug. But most of all, this Midwestern state has failed to recognize AIDS as
a health crisis, preferring to view it as a moral issue…. While we do have a few very
brave leaders who are stepping into the forefront of this issue to advocate for better
policy, services, funding, and education, the vast majority of our elected officials in
government and in education are failing the citizens of this state.
Completing her analysis, JX sums up her argument, addressing the multiple contributors to this failure to lead: “We are set up, just as San Francisco was in the 1980’s, with a conservative federal administration, a state that refuses to acknowledge that there is a problem, and an educational policy that avoids mention of condoms. The frustration I feel because of these unnecessary mistakes is compounded by the realization that the motivation for such mistakes has its roots in religious bigotry.”
HX addressed the failure of leadership in many arenas:
There was a failure of political leadership as typified by Ronald Reagan and various
agencies of the federal government. There was failure of the scientific establishment
to fully grasp the emerging threat of AIDS and how it should be met. There was a
failure of the higher education establishment epitomized by the reluctance of
universities to be associated with AIDS research. Perhaps, ironically, some of the gay Noonan / AIDS CASE STUDY 23
leadership failed to comprehend the magnitude of the growing crisis. There was
enough failure to go around for nearly every agency, department, doctor, politician,
scientist, and university. What AIDS revealed about America in the 1980s was not
only its lack of political, moral, and scientific leadership; it also lay bare what a
philosopher called ‘multiple deficiencies’ and the ‘increasing distances between
groups’ (Greene, 1988.) I believe all of these deficiencies go hand-in-hand to explain
why this country despite its vast scientific and political establishment, availability of
financial and medical resources, could not adequately address a new disease in its
midst.
The online discussion allowed students to express their concerns and learn about the way their colleagues experienced the text.
Prior to the weekend class, we read their papers with interest and delight, noting their willingness to engage in critical analysis and reflection. During the first few hours of class time, we reviewed critical, queer, and feminist theory, asking them to use these theories to analyze the AIDS case from a variety of perspectives (see earlier discussion of theory). Students shared their papers in small groups and continued their discussion of the text. The following morning we held an Academic Leadership Award program.
Academy Leadership Awards
We presented various leadership theories to students using a lecture/discussion format and then asked them to nominate a leader for the Academy Leadership Awards.
They each took a ballot consisting of a list of potential nominees created from the names of people in the Shilts’s text and leadership theories. Students completed the ballot, placing names under different leadership theories and discussing their nominees. Students located individual and collective acts of leadership in the case study, identifying examples of effective/ineffective leadership, as well as contrasts in ethical decisions and action.
Students explored ethical (Terry, 1993), transformational (Bass & Avolio, 1994), Noonan / AIDS CASE STUDY 24 contingency (Northouse, 2004), servant (Greenleaf, 1970), and team (Hill, 2004) theories of leadership (to name just a few), discussing “good” leaders who were not only effective, but also moral. Students discussed political theories of leadership and the use/abuse of power, identifying ways leaders served marginalized people or privileged groups.
Expanding their idea of leadership (moving from a positional or functional perspective to more sophisticated views of leadership), students examined how the context for leadership influences societal responses to AIDS. Drawing from social and organizational theory, students viewed leadership in the larger context and examined the collective effects of leadership on a personal, local, national and global scale. Following this discussion, students received instructions on how to move through experiential learning stations, designed to extend the discussion to justice, identity and leadership.
Experiential Learning Stations
We created four learning stations, “Policy”, “Culture”, “Power” and “Voices” to explore cultural diversity, leadership, and justice related to the AIDS case. Students worked in groups of four to five members and progressed through the station activities, learning and building their understanding together. Each station required students to complete an activity and leave a product or reflection of their work for the next group to consider. After completing all four stations, students returned to their original station, summarized the collective work of their colleagues and created a group product representing their views.
Students spent approximately 30 minutes at each station and a final 15 minutes to prepare their summary. The content of the stations are described in the next section.
Policy station
Students at the policy station reviewed CDC policy statements and the history of the
AIDS epidemic over the past 25 years. Noting the importance of mission and goals, students reviewed the core values of the CDC and its relationship to their strategic plan. After reviewing the information, they made recommendations for a five-year plan. As each group Noonan / AIDS CASE STUDY 25 passed through the station, more ideas about what the CDC might do to respond to the current global AIDS threat were shared. The original policy group eventually returned to their “home” station and summarized the recommendations. Recognizing the need for congruence between the mission and core values, students developed leadership skills in identifying the “moral action” needed to move from policy to leadership. Many creative solutions were explored, with most emphasizing preventive health care and education.
Culture station
Students described their personal culture and made a pie chart, called the “Wheel of
Cultural Influence” (Clemons, Heckman, & Lamb, 1998, p. 187), to describe their personal culture. Using categories such as race, class, gender, sexual orientation, age, religion and education, students described how their various “identities” influence their values, beliefs, and leadership style. Sharing a personal story to reflect on the influence of one identity on their life and leadership, students showed their colleagues how cultural differences influence their leadership. Their personal stories revealed both cultural difference and human relatedness -- consistent themes in our study of diversity.
Noting that others often assume or guess which factors might be highly influential to others, we discussed the importance of individual assumptions and interpretations as dynamic factors of one’s personal culture. For example, while others might think we are highly influenced by our experience as women, it might be our education that matters.
Education was a key factor in their lives not only in their personal development and success but also in their professional goals as educators – not a surprising finding among doctoral students.
Students also studied the gay/lesbian culture through the Gay and Lesbian History
Knowledge Game (n.d.). Drawing from a deck of cards filled with fascinating facts and history, students asked each other questions about gay and lesbian heroes and heroines, artists and intellectuals, and their roles in important historical events. Reflecting on their lack of insider knowledge, the hierarchy of cultural identity and its impact on the Noonan / AIDS CASE STUDY 26 perspectives of AIDS, students increased their cultural sensitivity to the members of a co- cultural (rather than sub-cultural, meaning less worthy) group. After playing the game, a debriefing group experience asked them to discuss several aspects of the game and their experience with co-cultural groups. These reflections were placed in an envelope for the
“returning” group to read and summarize.
Challenged by the knowledge game, students realized the value of cultural knowledge and experience. Realizing that the gay/lesbian culture was interwoven into their own culture without them knowing it, students identified connections with artists, leaders, and scientists that they valued, but did not realize were members of gay/lesbian communities. Reflecting on the experience, many shared the difficulties in becoming educated about and negotiating within diverse cultures. Admitting their lack of knowledge and experience is a first step.
Power station
We asked students to identify, describe, and assess sources of power and power relationships in the AIDS case study using the following directions:
Read through the list of “players” in the AIDS crisis and the related quotations about
power drawn from the text. Together create a “map of power” illustrating
relationships of the players portrayed in the book. Using the lens of critical theory,
discuss the unequal sources of power among the players and identify the ways that
power was used to influence and control others, perpetuating dominant ideologies.
Quotations such as: “If I had to blame one thing, it was the hunger for power” (Shilts,
1987, p. 546) or “Not beaten by AIDS but by the system” (p. 600), stimulated rich discussion.
Using symbols, characters, events, and actions, students illustrated the many ways power influenced the AIDS epidemic by creating a power map. As students traveled to the
“power station”, they added to the map and identified increasingly more complex Noonan / AIDS CASE STUDY 27 interrelationships and effects. Later students described how power served some while it excluded others. Connecting power to ethical leadership, students examined moral failures and also noted opportunities for “good leadership”.
Voices station
Using a “readers’ theater” approach to learning, students read aloud stories of people with AIDS and later created “quilt squares” to reveal their personal response or promise to
AIDS. Drawing on their creative thinking, students were asked to create a personal metaphor for the AIDS crisis on one side for the paper quilt square and then write a personal response or promise on the other side. This activity, “Keep the Promise”, was promoted during the World AIDS Campaign for 2005-2010: Stop AIDS (AVERT, 2005).
When the first group returned to the station, they “stitched” together a group quilt with scotch tape, arranging the quilt squares in a meaningful pattern. The class read the comments and examined the metaphors, seeing the many perspectives and interpretations of the AIDS crisis. This served as the closing activity to the AIDS case study; we involved our students with people around the globe who have joined the fight against AIDS.
Summary
During the study of AIDS, we asked students to hear the voices of the marginalized, question the decisions of leaders, and consider how they might work toward a more just response to one of the most pressing social issues of our time. Our goal was to encourage our students to move beyond the music played within our society to distract and dull their senses by dominant views and instead become more attuned to the sound of their internal voices (perhaps uncomfortable and judgmental regarding sexual orientation and privilege) and societal forces (the powerful, wealthy, and advantaged), which drown out the sounds of global suffering. Students explored how justice, identity, and leadership intersect using the
AIDS case study, allowing them opportunities to grow as ethical leaders and advocates of social justice. Using critical, feminist, and queer theory, students examined taken-for- Noonan / AIDS CASE STUDY 28 granted assumptions, awakening their critical consciousness through the case study of
AIDS. When leaders show “a willingness to consider alternative perspectives and choices, see the detrimental effects of unequal treatment and access to political economic and social resources, and take action in light of this knowledge” (Noonan, 2007a, p. 10), they serve as ethical leaders.
While critical seeing involves detecting bias, challenging dominant ideologies, and overcoming hegemony (Brookfield, 2005, p. 41), moral leadership requires ethical leaders to act on this knowledge, seeking to elevate the human condition through moral action
(Burns, 1978). Noddings (1998) makes the connection between critical theory and moral leadership:
From this perspective, the purpose of strong critical thinking is not only or
always to produce the best argument but to connect with others in a way that
would make the world demonstrably better – less violent, less cruel and
insensitive to the pain around us…. Looked at this way, critical thinking is
bigger than argumentation and different even from argumentation
supplemented with intellectual and moral virtues. It becomes the kind of
thinking that can “let the other be,” as Derrida puts it, in all his or her
otherness. (p. 94)
“Seeing the injustice in ‘social justice’ means examining how unequal power and acts of oppression preserve a social order that benefits some and disadvantages others”
(Noonan, 2007b, p. 203). An interactive and transformative experience for both the learner and teacher, the AIDS case study opened up possibilities for “the transformation of consciousness” occurring “in the intersection of three agencies-the teacher, the learner and the knowledge they together produce” (Lather, 1992, p. 121). The knowledge we produced in a community we created together during the AIDS case study allowed us to engage in dialogue and potentially grow in moral development and ethical leadership. The evidence for Noonan / AIDS CASE STUDY 29 this change appears in our students’ response to the curriculum and ultimately in their desires and decisions to create a more fair and just world.
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Dr. Sarah J. Noonan, an associate professor in the Leadership, Policy and Administration
Department at the University of St. Thomas in Minneapolis, Minnesota, teaches
doctoral and masters courses in leadership, intercultural communication, supervision
and professional development. Her most recent book with associate-author Thomas
Fish is entitled, Leadership through Story: Diverse Voices in Dialogue (2007).
Dr. Laurie Anderson Sathe, Adjunct Professor in the Department of Leadership, Policy
and Administration at the University of St. Thomas, teaches courses in leadership
and feminist/critical theory.